Healthcare Provider Details
I. General information
NPI: 1295730224
Provider Name (Legal Business Name): THOMAS BRADFORD LEMAY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/16/2005
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
46 SGT PRENTISS DR SUITE 204, NATCHEZ REGIONAL MEDICAL OFFICE BUILDING
NATCHEZ MS
39120-4792
US
IV. Provider business mailing address
5959 S SHERWOOD FOREST BLVD
BATON ROUGE LA
70816-6038
US
V. Phone/Fax
- Phone: 601-653-4927
- Fax: 601-897-0542
- Phone: 225-767-3900
- Fax: 225-765-9196
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | 15342 |
| License Number State | MS |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RI0011X |
| Taxonomy | Interventional Cardiology Physician |
| License Number | 08005 |
| License Number State | MS |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RI0011X |
| Taxonomy | Interventional Cardiology Physician |
| License Number | C-7116 |
| License Number State | AR |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RI0011X |
| Taxonomy | Interventional Cardiology Physician |
| License Number | 15342 |
| License Number State | MS |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: